| NPI | 1881684538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPENCER WITCHER Owner 270-651-2181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: KY 300060) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2017-05-12 |